Two anesthesiologists died after inadvertently overdosing on similar drugs to which they were secretly addicted. Each died with the needle in his arm, apparently miscalculating a dose. One had a new wife and a newer baby; the other a girlfriend. Neither was particularly depressed or lonely; rather, each was an upbeat, personable guy whose addiction escaped everyone’s suspicion. http://www.thedailybeast.com/articles/2014/04/24/the-secret-world-of-drug-addict-doctors.html

In December, a cardiovascular ICU nurse was found dead in the bathroom of a University of Michigan hospital. Months later, The Ann Arbor News reported that she died from an overdose of the opiate fentanyl and the benzodiazepine midazolam, two sedatives that are used for surgical patients. According to the CDC, drug overdose rates have more than tripled since 1990. More than 36,000 people died from drug overdoses in 2008, and most of these deaths were caused by prescription drugs. And prescription painkillers specifically were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined, the CDC says. http://healthleadersmedia.com/content/NRS-303903/Nurses-Arent-Immune-to-Prescription-Drug-Abuse

DelVecchio was found dead around 9:15 a.m. Dec. 6 in a locked bathroom at the Neuroscience Hospital. According to the autopsy, a syringe was also found in the bathroom and there were multiple needle marks on various parts of the body. Around 12:50 p.m. that same day, Sutton was found in a locked bathroom in the Cardiovascular Center, in cardiac arrest with a syringe and his doctor’s kit of pain medications. An autopsy report lists DelVecchio’s cause of death as fentanyl overdose. Sutton took morphine, police said. http://www.mlive.com/news/ann-arbor/index.ssf/2014/10/drug_thefts_at_u-m_hospital_a.html

I could keep going, there are far too many examples. These drugs are no joke, they are deadly. When combined with other drugs, even more so. A good example of this deadly combination is fentanyl and midazolam. Midazolam had an amnesiac effect so the user doesn’t realize how much they are taking. If Midazolam and fentanyl are taken together, the user, forgetting how much fentanyl they have taken, can take too much. The consequence can be respiratory failure and death.

As healthcare workers we think we know how much to take. We think we can take just a little bit more. Because we are ‘professionals’ we won’t overdose, we’re too smart for that. One day after work I had a 10mg vial of midazolam and a 1g vial of ketamine. When I woke a few hours later in my bed, both were gone. I had no memory of taking any of it accept the first injection of midazolam. I had needle marks all over my hands and arms…no memory of inflicting them. Had the ketamine been fentanyl I would now be dead. I wouldn’t have realized what I was doing because the versed wiped out any ability to judge what I was doing. I was terrified when I realized I had taken all of it. That did not stop me from continuing my drug use. It did not change my behavior in any way. In fact, my drug use continued to escalate.

I am a smart nurse. I know what these drugs can do. Knowledge did not stop me. It did not make me immune to the dangers of these powerful drugs. Knowledge actually made me stupid. To think I could control the effects of drugs or my reaction to them was naive. I did not overdose. I ended up in jail for stealing drugs. I was lucky. Many are not.

There are a few different types of treatment options for chemical dependency issues. Deciding which is right for you should be a decision made with input from your Primary Care Doctor or our Counselor. Listen to them, they have the experience to make that decision, you don’t. As my addiction progressed I sought help from a Counselor. She told me I needed inpatient treatment. I told her I couldn’t go. I had 2 children to support, I had a job, I couldn’t leave. She said we could try outpatient treatment, but if I failed that I would need to go inpatient. Had I listened to her I may have avoided the felony conviction and the 4 months of jail time. But I didn’t listen, I thought I knew better. I thought if I could just figure out what was wrong with me I could quit using. It doesn’t work that way…I had to quit using first, then I could work on myself. But I didn’t listen, instead I lied to her, telling her I wasn’t using when I was, wasting her time and mine. Until I got in real trouble, I didn’t listen. I had to hit bottom before I could stop using and get the help I needed. If you are playing around with treatment, stop it, it is not a game. Lives are lost due to this disease. Bad enough to lose your job and freedom, but even worse to lose your life. Listen to what the Counselor, Therapist, Doctor tell you, do it before circumstances force you to.

Scientific research shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:

Addiction is a complex but treatable disease that affects brain function and behavior.

No single treatment is appropriate for everyone.

Treatment needs to be readily available.

Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.

Remaining in treatment for an adequate period of time is critical.

Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.

Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.

An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.

Many drug–addicted individuals also have other mental disorders.

Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.

Treatment does not need to be voluntary to be effective.

Drug use during treatment must be monitored continuously, as lapses during treatment do occur.

Residential treatment: a residential center provides intensive treatment in comfortable settings. Residential patients are engaged in treatment seven days a week. As a result, patients can make positive behavior changes in a relatively short time.

Inpatient hospitalization: most addicts have mental health issues, this type of treatment provides distinct mental health programs for people dealing with a wide variety of acute psychiatric symptoms. It can also offer withdrawal management (detoxification) services for adults.

Partial hospitalization: these types of programs offer patients extra support when transitioning from inpatient to outpatient treatment, or as an alternative to inpatient treatment. The programs provide therapy, education, support and medication monitoring while allowing patients to remain connected to family and other support systems. Patients typically attend five days per week, six hours a day, for an average of four to six weeks.

Intensive outpatient treatment: Similar to partial hospitalization, these programs provide structured treatment while patients stay involved with work, family or school commitments. Patients typically attend four days a week, three hours a day, for an average of six to eight weeks.

Jail: Treatment in a criminal justice setting can succeed in preventing an offender’s return to criminal behavior, particularly when treatment continues as the person transitions back into the community. Studies show that treatment does not need to be voluntary to be effective.

12 Step programs: these programs are free for people suffering from alcohol abuse and addiction. Program participants follow a set of recovery steps to achieve and maintain abstinence from alcohol and other drugs. Many people use a sponsor to help them through the process. The only requirement is a desire to stop drinking.

This is by no means an exhaustive list, as I said, the decision on which is right for you should be a joint decision. The most important thing is to get help, do not delay, listen to those who want to help. If you are chemically addicted you are NOT in the right mind to make these critical decisions. Stop fighting and get help…now.

I think next week we will focus on the fatal nature of this disease, until then, be safe…